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Individual

JOSEPH R DEPALO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1708 N FEDERAL HWY, LAKE WORTH, FL 33460-6668
(561) 944-6647
Mailing address
833 UNIVERSITY BLVD APT 303, JUPITER, FL 33458-3072
(508) 596-3412

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
30025262
OH
1223P0221X
Pediatric Dentistry
30025262
OH
1223P0221X
Pediatric Dentistry
Primary
DN24713
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0274059
OH
Enumeration date
02/13/2017
Last updated
07/22/2022
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